Table 2 Included descriptions of DFHs
From: Characteristics of dementia-friendly hospitals: an integrative review
Publication | Research | Phenomenon of interest (DFH) | |
Primary publication: Schmidt, 2017 [45] Additional publications: Lautenschläger et al., 2016 [64] Country: Germany Publication type: Master thesis, practice article Funding: Not reported | Aim: To identify central characteristics of a dementia-sensitive hospital and to develop a literature-based instrument to evaluate the dementia-sensitivity of a hospital Design/Methods: Literature review, qualitative design (expert interviews, deductive content analysis), quantitative design Participants: Professional dementia experts (n = 6) Professions: nursing, therapists, experts from gerontology, architects | Used Term: Dementia-sensitive hospital Definition: “A dementia-sensitive hospital is characterized overall by a processes and strategies based on the needs of people with dementia (PwD). Due to a high level of acquired, communicative competence in the interaction with PwD and a positive attitude of the staff with at least basic dementia training, the PwD and their significant persons are supported during their hospital stay according to their needs. In addition to an early identification of PwD as the prerequisite for an individually tailored treatment and care process, an oriented environment supports a high degree of autonomy and safety” (Schmidt, 2017 [45], p. 39) Development: Based on the literature, expert interviews, the SPACE principles Target group: People with dementia | Key components: -Staff knowledge and attitude -Cross-sectoral networking -Involvement and support of relatives -Assessment of dementia/other care phenomena -Tailored treatment process and care plan -Environmental design |
Primary publication: Toubol et al., 2020 [43] Additional publications: - Country: Denmark Publication type: Research article Funding: No financial support | Aim: To explore and describe stakeholders’ perspectives of a dementia-friendly hospital Design/Methods: Qualitative design, focus group interviews, thematic analysis Participants: People with dementia (n = 4): Age group ≥ 65: n = 4 Relatives (n = 5): Age ≥ 65: n = 2, Relationship: spouse (n = 4), daughter (n = 1) Hospital staff (n = 4): Age group ≤ 65: n = 4, Profession: cleaner (n = 1), head of department (n = 1), nurse (n = 1), physiotherapist (n = 1) Representatives from Alzheimer Association (n = 3): Age group ≥ 65: n = 2, Membership background: relative (n = 1), relative and nurse (n = 1), nurse (n = 1) | Used Term: Dementia-friendly hospital Definition: Not reported Development: Results of the qualitative analysis Target group: People with dementia in hospitals | Key components: Seeing the person behind the dementia diagnosis -Balance of knowledge o About the person oAbout dementia -Facilitating protection oRespectful disclosure of the dementia diagnosis oProtective surroundings oInvolvement of significant others |
Primary publication: Wu et al., 2019 [44] Additional publications: - Country: Taiwan Publication type: Research article Funding: Department of Health, Taipei City Government (105MN14 M); and Healthy Aging Research Center, Chang Gung University (EMRPD1H0361, EMRPD1H0551) | Aim: To identify dementia-friendly community indicators from the perspectives of people with dementia and family caregivers Design/Methods: Qualitative Design, interviews, content analysis Participants: People with dementia (n = 16): Age: 72.12 (SD 9.38) Dementia level: severe (n = 0), moderate (n = 5), mild (n = 10), mild cognitive impairment (n = 1) Family caregivers (n = 20): Age: 60.15 (SD 10.05) Relationship: spouses (n = 9), daughters (n = 8), son (n = 1), daughter‐in‐law (n = 1), sister (n = 1) Dementia level (person cared for): mild (n = 10), moderate (n = 8), severe (n = 2) | Used Term: Dementia-friendly hospital Definition: Not reported Development: Results of the qualitative analysis Target group: People with dementia in communities | Key components: -Provide integrated care -Short waiting times -Staff attitude (friendly and supportive) |
Publication | Recommendations | Phenomenon of interest (DFH) | |
Primary publication: BMFSFJ, 2020 [38] Additional publications: BMFSFJ, 2017 [65] Country: Germany Publication type: Guideline Funding: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth | Aim: To collect different approaches to create a strategic direction toward a dementia-sensitive hospital Development: Based on the experiences of the Local Alliances for People with Dementia and the results of a “dementia and hospital” symposium with contributions from various experts (e.g., research, hospitals, dementia/geriatric associations) Method: Not reported Created by: Network Local Alliances for People with Dementia in agreement with Federal Ministry for Family Affairs, Senior Citizens, Women and Youth Created for: Hospitals in Germany | Used Term: Dementia-friendly/dementia-sensitive hospital/structures Definition: Not reported Development: See development of recommendation Target group: Patients with dementia | Key components -Staff knowledge -Transitional management -Environmental design -Daily structure and activities -Involvement of volunteers and relatives |
Primary publication: Horneber et al., 2019 [42] Additional publications: - Country: Germany Publication type: Practice book Funding: Not reported | Aim: To be a toolbox for practitioners who are involved in creating a dementia-sensitive hospital Development: Not reported Created by: The chapters were written by different experts (e.g., healthcare management, nursing, medicine, ethics, architecture, geriatrics, theology, technology) Created for: Healthcare professionals in hospital | Used Term: Dementia-sensitive hospital Definition: Not reported Development: Not reported Target group: Patients with dementia and/or delirium | Key components -Environmental design -Sufficient staff and volunteers and expertise -Communication -Admission management -Identification of cognitive impairment -Diagnostic and treatment of dementia/other care phenomena -Discharge management -Corporate culture (spirituality, ethical reflection, protection of patients’ rights) |
Primary publication: Juraszovich and Rappold, 2017 [41] Additional publications: - Country: Austria Publication type: Guideline Funding: Federal Ministry of Health and Women's Affairs and the Federal Ministry of Social Affairs | Aim: To support the creation of suitable conditions for dementia-competent hospitals Development: Based on the SPACE principles and together with experts Method: Expert panel Participants: Experts (n = 12) from different disciplines and departments in Austria (e.g., hospital management, hospital board, geriatric societies, hospital societies, politics) Created by: Austrian National Public Health Institute Created for: Highest level of responsibility and decision-makers, managers of all professional groups in the hospital | Used Term: Dementia-sensitive hospital, dementia-competent hospital (it seems that the terms were used synonymously) Definition: “Being dementia competent means being attentive to the concerns and needs of people with dementia, responding to their changed lifestyles, pace, perceptions and needs, and adapting and adjusting processes accordingly. This works well when the entire hospital management is behind the issue” (Juraszovich and Rappold, 2017 [41], p. 1) Development: See development of recommendation Target group: Patients with dementia | Key components -Staff knowledge and sufficient staff -Partnership involving healthcare providers and relatives -Assessment and risk identification -Individual care -Environmental design -Dementia governance |
Primary publication: Kirchen-Peters and Krupp, 2019 [39] Additional publications: Kirchen-Peters and Krupp, 2019 [66] Country: Germany Publication type: Practice Guideline Funding: Robert-Bosch-Stiftung | Aim: To systematically collect the experience and knowledge from existing projects and the literature, and to process them into a practical guide for the modular implementation of measures in hospitals Development: Based on best practice projects, dementia strategies, literature and interviews Methods: Literature search, document analysis, project analysis, interviews/focus group interviews (qualitative content analysis) Participants: Professional dementia experts (n = 15) with an expertise of care concepts in hospitals for people with cognitive impairments, project stakeholders (n = 17) (not further defined) Created by: Robert-Bosch-Stiftung, in cooperation with the Institute for Social Research and Social Economy Created for: Managers and staff of acute hospitals | Used Term: Dementia-sensitive hospital Definition: “Thus, dementia-sensitivity presupposes sensory sensitivity and is intended to help perceive the needs and expectations of people with dementia and integrate these into the design of care structures and processes. Dementia sensitivity serves as a professional basis for the coordinated development of dementia-sensitive structures and processes” (Kirchen-Peters and Krupp, 2019 [39], p. 22) Development: See development of recommendation Target group: Patients with dementia | Key components -Staff knowledge -Delirium management -Identification and treatment of dementia -Consultation and liaison services -Special care unit -Dementia-sensitive emergency department -Daily structuring and activities -Involvement and support of relatives -Environmental design -Cross-sectoral approaches |
Primary publication: National Dementia Action Alliance, 2021 [40] Additional publications: - Country: England Publication type: Charter Funding: Not reported | Aim: To enable hospitals to create a dementia-friendly environment for people with dementia, their families and caregivers in England Development: Not reported Created by: National Dementia Action Alliance (not further described) Created for: Staff and volunteers in hospitals | Used Term: Dementia-friendly hospital Definition: Not reported Development: Based on the SPACE principles. Following recommendations from the Department of Health and Social Care, principal volunteering was added Target group: People with dementia, their families and caregivers | Key components -Staff knowledge -Partnership with people with dementia, their -relatives/caregivers -Assessments of the needs of people with dementia and their relatives -Person-centered care -Environment -Governance -Volunteering |
Primary publication: Wallner, 2016 [37] Additional publications: - Country: Austria Publication type: Guideline Funding: Not reported | Aim: To describe the overall concept of a “dementia-friendly hospital” for a specific hospital Development: Not reported Created by: Hospital of St. John of God Wien. The Author was a part of the expert panel of B Juraszovich and E Rappold [41] Created for: Responsible persons, decision-makers and the management level of the Hospital of St. John of God Wien | Used Term: Dementia-friendly hospital Definition: Not reported Development: Based on the SPACE principles Target group: People of dementia | Key components -Staff knowledge and sufficient staff -Involvement of relatives -Transitional management -Involvement of volunteers -Working together with external care providers -Information exchange within the hospital -Identification and diagnostics of dementia -Consideration of dementia in care -Environmental design |
Publication | Practice projects | Phenomenon of interest (DFH) | |
Primary publication: Blumenrode, 2018 [35] Additional publications: Koch et al., 2019 [47] Country: Germany Publication type: Practice article, book chapter Funding Robert-Bosch-Stiftung | Aim: To adapt existing care and treatment services to the needs of patients with dementia or older patients in the emergency department and an orthopedic pilot ward Created by: Hospital: The clinic Stuttgart (2200 beds) Project team: Director and experts (e.g., medicine, nursing, therapists, economic, geriatrics, education, social work, architecture) Partially involved: Other stakeholders of the pilot ward, case management, corporate development, the Esslingen University of Applied Sciences, the Alzheimer's Association and volunteers Scientific evaluation: Individual components | Used Term: Dementia- and age-sensitive hospital Definition: Not reported Development: Based on existing structures and interventions from international “good practice projects” and recommendations Target group: Older patients and/or patients with dementia | Key components -Identification and diagnostics of cognitive impairments -Dementia and age-sensitive treatment -Staff knowledge -Dementia experts -Delirium prevention -Daily activities -Environmental design -Person accompanying during surgery -Discharge management |
Primary publication: Koczy et al., 2017 [36] Additional publication: Koczy, 2014 [67] Country: Germany Publication type: Practice articles Funding: Robert-Bosch-Stiftung | Aim: To develop and implement a concept for a dementia-sensitive hospital Created by: Hospital: Robert-Bosch-Hospital Stuttgart (800 beds) Scientific evaluation: Not reported | Used Term: Dementia-sensitive hospital Definition: Not reported Development: Not reported Target group: Patients with dementia | Key components -Special care unit -Identification of cognitive impairments -Staff knowledge -Pathway |
Primary publication: Malteser, 2021 [29] Additional publication: Sottong, 2020 [46], Sottong and Hoffmann, 2014 [51], Malteser and DIP, 2017 [68], Hoffmann, 2015 [69] Country: Germany Publication type: Poster, conference presentation, practice articles, scientific report Funding: Partly: Free State of Saxony | Aim: To transfer the Swedish Silviahemmet Foundation's “Palliative Care Concept for the Care and Support of People with Dementia” to Germany and to develop a care strategy for Malteser hospitals Created by: Hospitals: Malteser St. Hildegardis Hospital Cologne, and other Malteser hospitals in Germany Further project: Hospital: St. Carolus Hospital Görlitz Project team: Different managers from nursing, medicine, house technology, service personnel, administration, functional services, social services and pastoral care Project advisory board: Different representatives of Alzheimer associations, research, county and healthcare Scientific evaluation: Special care unit, the further project | Used Term: Dementia-friendly hospital, dementia-sensitive hospital Definition: Not reported Development: Based on the palliative care concept of Silviahemmet Target group: People with dementia in hospital and their relatives | Key components -Special care unit -Daily structure -Environmental design -Staff knowledge -Identification of cognitive impairments -Diagnostic management -Involvement of relatives |
Primary publication: Motzek et al., 2019 [31] Additional publication: - Country: Germany Publication type: Book chapter Funding: Partly: Robert-Bosch-Stiftung, Emmy-Noether-Program | Aim: To develop and implement a dementia sensitive hospital concept Created by: Hospital: Deaconess Hospital Dresden (220 beds) Steering group: persons from the Technische Universität Dresden, Protestant University of Applied Sciences Dresden, the Deaconess Hospital Dresden (the nursing and quality management), external employee Project team: nursing, medical, administrative and service staff, and experts (relative and staff education, architecture, patient orientated procedures and concepts) Scientific evaluation: Individual components | Used Term: Dementia-sensitive hospital Definition: Not reported Development: By various experts Target group: Patients with dementia | Key components -Patient-orientated procedures and concepts -Pain and delirium management -Daily structure -Staff knowledge -Environmental design -Support of relatives |
Primary publication: Poppele et al., 2018 [30] Additional publications: Schmitt-Sausen, 2015 [49], Lüdecke, Poppele and Kofahl, 2016 [50], Förster, Kügler and Poppele, 2018 [53], Lüdecke, Peiser and Döhner, 2016 [70], Wunder, 2016 [71] Country: Germany Publication type: Book chapter, practice articles, scientific report, guideline Funding: Robert-Bosch-Stiftung | Aim: To record and appropriately care for patients over 65 years of age with cognitive impairment during their hospital stay Created by: Hospital: Protestant Hospital Alsterdorf Hamburg (293 beds) Scientific evaluation: Individual components | Used Term: Dementia-sensitive hospital Definition: Not reported Development: By the hospital with different healthcare professionals (e.g., physicians, nurses, therapists, psychologists) and representatives of the Alzheimer Association Target group: Older people (> 65 years) with cognitive impairments, their relatives, medical, nursing, and therapeutic staff | Key components -Identification of dementia or delirium -Staff knowledge -Guideline for preserving patient autonomy -Environmental design -Special care unit -Discharge management -Consultation and liaison services |
Primary publication: Schneider, 2019 [32] Additional publications: Fuchs and Lang, 2015 [72] Country: Germany Publication type: Book chapter, scientific report Funding: Earmarked donation and own funds | Aim: Organizational development to become a dementia-sensitive hospital Created by: Hospital: General Hospital Bamberg Project team: nursing staff Scientific evaluation: Individual components | Used Term: Dementia-sensitive hospital Definition: Not reported Development: Stage model was developed by the nursing director based on nursing theories and models by Orem and Wittneben Target group: Patients with cognitive impairments, dementia or delirium | Key components -Interdisciplinary treatment and care concepts -Identification and fulfilment of specific care needs -Staff knowledge -Dementia experts -Care counseling service -Additional time resources -Special care units -Qualification mix -Specialized departments for geriatrics -Involvement of pre/post-acute providers |
Primary publication: Schnetter, 2015 [33] Additional publications: - Country: Germany Publication type: Practice article Funding: Not reported | Aim: To implement a concept for the care of people with dementia in hospital as a basis for a dementia-sensitive hospital Created by: Hospital: St. Marien Amberg Hospital Scientific evaluation: Not reported | Used Term: Dementia-sensitive clinic Definition: Not reported Development: Not reported Target group: People with dementia and their relatives | Key components -Geriatric assessment -Involvement of relatives -Environmental design -Special care concepts -Information exchange with external care providers -Staff knowledge |
Primary publication: Thomas and Schlauß, 2017 [34] Additional publications: Klimmer, 2017 [52], Kratz and Diefenbacher, 2019 [54] Country: Germany Publication type: Practice articles, book chapter Funding: Partly: Robert-Bosch-Stiftung | Aim: To implement a comprehensive treatment and support concept for people with dementia Created by: Hospital: Queen Elisabeth Herzberge Protestant Hospital (750 beds) Scientific evaluation: Pending | Used Term: Dementia-sensitive hospital; dementia-friendly hospital Definition: Not reported Development: Based on evidence of delirium prevention and best practice projects Target group: Patients with dementia | Key components -Dementia project coordinator -Staff knowledge -Counseling and liaison services -Special support services by trained care-aid staff -Special care concepts -Screening of cognitive impairment -Risk identification -Prevention of perioperative delirium -Support of relatives -Special care unit -Specialized departments for geriatrics -Environmental design -Cross-sectoral network |